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Niloy Bhattacharjee, Sujata Barma, Nandita Konwar, Saikat Dewanjee, Prasenjit Manna
Diabetic nephropathy (DN), a chronic complication of diabetes, is charecterized by glomerular hypertrophy, proteinuria, decreased glomerular filtration, and renal fibrosis resulting in the loss of renal function. Although the exact cause of DN remains unclear, several mechanisms have been postulated, such as hyperglycemia-induced renal hyper filtration and renal injury, AGEs-induced increased oxidative stress, activated PKC-induced increased production of cytokines, chemokines, and different inflammatory and apoptotic signals...
August 25, 2016: European Journal of Pharmacology
Paula Mosińska, Martin Storr, Jakub Fichna
AST-120 (kremezin) exhibits its favourable effects in reducing the levels of renal toxins by selective adsorption of low molecular weight substances from the intestinal lumen. So far, a vast majority of studies were focused on the role of AST-120 in the treatment of chronic kidney diseases and cardiovascular disorders, and positive therapeutic effects of the agent have already been confirmed in clinical conditions. Up to the present, there are only a few studies regarding the role of AST-120 in irritable bowel syndrome (IBS)...
September 2015: Therapeutic Advances in Gastroenterology
Hiroyuki Abe, Risa Morikawa, Makoto Otsuka
The kinetic and mechanistic profiles of three pharmaceutical spherical carbon adsorbents, Kremezin as the brand product and two generics (Merckmezin and spherical carbon adsorbent "Mylan"), were compared. Five non-ionic active pharmaceutical ingredients with molecular weights of 136.1-424.1 Da were used as adsorbates. The results of Boehm titration, the standard method to qualify acidic or basic functional groups on a carbon surface, suggested distinctly different quantitative characteristics of each functional group among the three adsorbents...
March 1, 2013: Colloids and Surfaces. B, Biointerfaces
Hiroyuki Abe, Makoto Otsuka
In this study, various physicochemical characteristics were evaluated for three pharmaceutical spherical carbon adsorbents, Kremezin as a brand product and its generics; Merckmezin and Spherical Carbon Adsorbent "Mylan". Scanning electron microscopic observations, measurements of specific surface area, particle sizes, and pore volume distributions by mercury intrusion porosimetry, and dynamic vapor sorption (DVS) analysis were conducted. Compared to Kremezin, Merckmezin is dented with a small pore-rich structure; pores of less than 10nm make up 43% (Kremezin) and 68% (Merckmezin) of total pore volume...
December 1, 2012: Colloids and Surfaces. B, Biointerfaces
Raymond Vanholder, Eva Schepers, Anneleen Pletinck, Nathalie Neirynck, Griet Glorieux
Although protein-bound uremic retention solutes are recognized as 1 of the 3 main categories of uremic retention solutes, they only recently have been submitted to thorough analysis. In vitro and ex vivo data link both p-cresyl sulfate and indoxyl sulfate, two of the main compounds of this solute group, to negative impact on the cardiovascular system and progression of kidney failure. Recent in vivo observational data also relate concentration of these compounds to survival outcome, inflammation, and vascular disease in different, even moderate, stages of chronic kidney disease...
January 2012: Journal of Renal Nutrition
Miyako Yoshida, Mai Hazekawa, Tamami Haraguchi, Takahiro Uchida
The purpose of this study was to evaluate the effect of three swallowing aids on the adsorbent properties and palatability of a mixture of the oral charcoal adsorbent, Kremezin®. None of the swallowing aids had any effect on the adsorption of indole by Kremezin®, either in vitro and in vivo. In gustatory sensation tests of the palatability of the swallowing aids with Kremezin®, 14 items were evaluated according to the semantic differential (SD) method. Factor analysis of the results identified two main factors 'Remaining after removing from mouth' and 'Sense of holding in mouth' as predominantly determining the palatability...
2011: Chemical & Pharmaceutical Bulletin
Su Hyun Kim, Jung Yeon Ghee, ShangGuo Piao, Dong He Han, Ji-Hyun Song, Hye Eun Yoon, Bum Soon Choi, Jin Kim, Fuyuhiko Nishijima, Kazumi Obara, Noriyuki Ishikawa, Chul Woo Yang
BACKGROUND: Removal of uraemic toxins by AST-120 (Kremezin(®)) decreases the progression of chronic kidney disease by reducing oxidative stress. We performed this study to evaluate whether AST-120 has a similar effect on progression of cyclosporine (CsA)-induced renal injury. METHODS: Two separate studies were performed in adult Sprague-Dawley rats. First, AST-120 was administered with CsA (15 mg/kg) for 4 weeks (early treatment). Second, AST-120 was administered to the rats for 3 weeks after treatment with CsA for 3 weeks (delayed treatment)...
May 2011: Nephrology, Dialysis, Transplantation
Hiroshi Shibahara, Nami Shibahara
BACKGROUND: The detailed mechanisms and treatment methods of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) are not fully understood. We conducted a prospective study in CHF patients manifesting CKD to examine if AST-120 (Kremezin) improves cardiac and renal functions. METHODS: Twenty outpatients with CHF manifesting moderate CKD (serum creatinine 1.3-2.0 mg/dL) were studied. The patients had received AST-120 at a dosage of 6 g/day in combination with existing medications for 24 months...
September 2010: Journal of Nephrology
Sun Ha Lee, Bo Young Nam, Ea Wha Kang, Seung Hyeok Han, Jin Ji Li, Do Hee Kim, Seung Hye Kim, Seung-Jae Kwak, Jung Tak Park, Tae Ik Chang, Tae-Hyun Yoo, Dae Suk Han, Shin-Wook Kang
BACKGROUND: Previous studies have demonstrated that AST-120 (Kremezin((R))), a well-known oral adsorbent, inhibits the progression of diabetic (DM) and non-DM chronic kidney disease along with a decrease in oxidative stress. This study was undertaken to investigate whether AST-120 could reduce oxidative stress and ameliorate the development of nephropathy in experimental DM rats with normal renal function. METHODS: Rats were injected with diluent (C, n = 16) or 65 mg/kg streptozotocin intraperitoneally (DM, n = 16), and eight rats from each group were treated with chow containing 5% AST-120...
July 2010: Nephrology, Dialysis, Transplantation
Eva Schepers, Griet Glorieux, Raymond Vanholder
Part of the uremic retention solutes are generated in the intestine, but this option is rarely discussed in the literature. In this publication, we describe consecutively the role of the intestine in generating uremic retention solutes, the pathophysiological importance of the generated solutes and therapeutic options that are inspired by this knowledge. Apart from its role as a route via which uremic toxins or their precursors enter the body, the intestine also acts as an active player by presenting more precursors for fermentation due to disturbances in assimilation caused by uremia, followed by alterations in further processing related to changes in the composition of the fermenting flora...
2010: Blood Purification
Mohamad Rasm Al Sibae, Brendan M McGuire
Hepatic encephalopathy (HE) is a common reversible neuropsychiatric syndrome associated with chronic and acute liver dysfunction and significant morbidity and mortality. Although a clear pathogenesis is yet to be determined, elevated ammonia in the serum and central nervous system are the mainstay for pathogenesis and treatment. Management includes early diagnosis and prompt treatment of precipitating factors (infection, gastrointestinal bleeding, electrolyte disturbances, hepatocellular carcinoma, dehydration, hypotension, and use of benzodiazepines, psychoactive drugs, and/or alcohol)...
June 2009: Therapeutics and Clinical Risk Management
Naoto Inaba, Makoto Aoyagi, Takehito Tanase, Yoshitaka Maeda, Tatsuo Shiigai, Shigeo Tomura, Eiichirou Kanda
BACKGROUND: Two activated charcoal preparations, Kremezin (K) and Merckmezin (M), are both available in Japan and derived from similar materials. However, their microstructures are distincty different, and possibly reflect differences in their properties of absorbance. To evaluate the difference between K and M, we investigated the effects of K and M on the clinical parameters related to uremia in pre-dialysis patients. METHODS: A prospective, randomized, open-label, two-arm, parallel-group comparative clinical trial was planned, as follows...
2009: Nihon Jinzo Gakkai Shi
Yoshihiro Fukuda, Masakazu Takazoe, Akira Sugita, Tadashi Kosaka, Fukunori Kinjo, Yoshimasa Otani, Hisao Fujii, Kazutaka Koganei, Kazuya Makiyama, Toshio Nakamura, Takeyasu Suda, Shojiro Yamamoto, Toshifumi Ashida, Akira Majima, Norikazu Morita, Kazunari Murakami, Nobuhide Oshitani, Kazuya Takahama, Masahiro Tochihara, Tomoyuki Tsujikawa, Makoto Watanabe
OBJECTIVES: Anal fistulas are common in individuals with Crohn's disease (CD). We sought to evaluate the efficacy of oral spherical adsorptive carbon (AST-120) (Kremezin; Kureha Corporation, Tokyo, Japan) for the treatment of intractable anal fistulas in patients with CD. METHODS: In this multicenter, randomized, double-blind, placebo-controlled trial, patients with CD and at least one active anal fistula under treatment were assigned to receive either AST-120 or placebo for 8 wk...
July 2008: American Journal of Gastroenterology
Kazunori Konishi, Shigeru Nakano, Shin-ichi Tsuda, Atsushi Nakagawa, Toshikazu Kigoshi, Daisuke Koya
There is little clinical evidence when AST-120 should be prescribed for subjects with early stage overt diabetic nephropathy. We therefore designed a prospective, randomized, controlled study for subjects with type 2 diabetes (serum creatinine <1.5mg/dl and urinary protein >0.5g/day) in November, 2001. The primary end point was defined as exceeding 2mg/dl of serum creatinine, and the secondary end point was defined as introducing a hemodialysis. Twenty-two subjects were selected, and after excluding 6 drop-out subjects, 16 subjects (10 in the control group; 6 in the KRM group) finally entered the study...
September 2008: Diabetes Research and Clinical Practice
Noriaki Yorioka, Kei Kiribayashi, Takayuki Naito, Satoshi Ogata, Yukio Yokoyama, Yasufumi Kyuden, Takahiko Ogawa, Koji Wada, Kanoko Hayashi, Akira Hirabayashi
BACKGROUND: A low-protein diet and treatment with renin-angiotensin system (RAS) blockers can delay the progression of chronic kidney disease (CKD). The oral adsorbent AST-120 (Kremezin) has a renoprotective effect by reducing serum levels of uremic toxins. We investigated the influence of AST-120 on the preservation of renal function in patients with CKD. METHODS: Twenty-eight patients were randomized to 2 groups: 15 patients receiving 6.0 g of AST-120 daily for 12 months plus a low-protein diet and RAS blocker therapy (group A) and 13 patients who were not given AST-120 (group B)...
March 2008: Journal of Nephrology
S Yamagishi, K Nakamura, T Matsui, H Inoue, M Takeuchi
The pathological role of the non-enzymatic modification of proteins by reducing sugars has become increasingly evident in various disorders. It is now well established that early glycation products undergo progressive modification over time in vivo to the formation of irreversible cross-links, after which these molecules are termed "AGEs (advanced glycation end products)". AGEs have been implicated in the development of many of the pathological sequelae of diabetes and aging, such as diabetic microangiopathy, ischemic heart disease and neurodegenerative diseases...
2007: Medical Hypotheses
Kentaro Taki, Toshimitsu Niwa
OBJECTIVES: Indoxyl sulfate shows nephrotoxicity and is a stimulating factor for progression of chronic kidney disease (CKD). This study was conducted to determine (1) whether the indoxyl sulfate-lowering capacity of oral sorbents (Kremezin [AST-120], Kureha Corporation, Tokyo, Japan; Merckmezin, Merck Hoei Ltd., Osaka, Japan) affects the prognosis of kidney function in CKD, and (2) whether oral sorbents reduce the markers of oxidative stress. METHODS: Rats with CKD were produced by 4/5 nephrectomy and were randomized into 3 groups: control rats, Merckmezin-treated rats, and Kremezin-treated rats...
January 2007: Journal of Renal Nutrition
Muneaki Hidaka, Keishi Yamasaki, Manabu Okumura, Tetsuya Ogikubo, Tomomi Iwakiri, Nao Setoguchi, Kentaro Nishida, Kimihiro Nagai, Tsuyomu Ikenoue, Kazuhiko Arimori
PURPOSE: One of the significant dose-limiting toxicities of irinotecan hydrochloride (CPT-11) is severe diarrhea due to impairment of the intestinal membrane induced by the excreted CPT-11 and its metabolites. AST-120 (Kremezin) is a prominent oral adsorbent that consists of porous spherical carbonic particles. To evaluate whether Kremezin can prevent the diarrhea induced by CPT-11, we investigated the adsorption characteristics of CPT-11 and its metabolites onto Kremezin in vitro and in vivo...
February 2007: Cancer Chemotherapy and Pharmacology
Hye-Young Kang, Woohyun Cho, Sunmi Lee, Hyung-Jong Kim, Ho Yong Lee, Tae-Wook Woo
OBJECTIVES: We wanted to evaluate the economic value of a pharmaceutical product, Kremezin, for treating patients with chronic renal failure (CRF) by estimating the amount of cost savings due to its effect for delaying the initiation of dialysis treatments. METHODS: We defined a conventional treatment for CRF accompanied by Kremezin therapy as 'the treatment group' and only conventional treatment as 'the alternative group.' The types of costs included were direct medical and non-medical costs and costs of productivity loss...
March 2006: Journal of Preventive Medicine and Public Health, Yebang Ŭihakhoe Chi
Gerald Schulman, Rajiv Agarwal, Muralidhar Acharya, Tomas Berl, Samuel Blumenthal, Nelson Kopyt
BACKGROUND: AST-120 (Kremezin; Kureha Chemical Industry Co Ltd, Tokyo, Japan) is an orally administered adsorbent showing adsorption ability superior to activated charcoal for certain organic compounds known to be precursors of substances that accumulate in patients with chronic kidney disease (CKD) and that are believed to accelerate the decline in kidney function. AST-120 is approved in Japan for prolonging time to hemodialysis therapy and improving uremic symptoms in patients with CKD...
April 2006: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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